Tag Archives: autism

States Slow to Move on Mandated ABA Coverage

Months after the federal government passed legislation requiring states to include coverage of therapeutic autism services such as applied behavior analysis (ABA) in their Medicaid programs, progress is slowly being made. 

It was determined in July of this year that Medicaid programs nationwide must cover “medically necessary diagnostic and treatment services” to children with autism spectrum disorders (ASD) including behavioral therapy, occupational and speech therapy, personal care services, and medical equipment. 

California is the first state to comply, issuing a bulletin to plan administrators September 15 explaining that Medi-Cal, California’s Medicaid program, will cover evidence-based behavioral intervention services including ABA for autistic children up to the age of 21. Coverage is available immediately for those who qualify for the program and will be retroactive to July 7, 2014. 

Connecticut and Nevada are expected to be the next states to expand their Medicaid coverage of autism services in compliance with the federal mandate, but no official announcements or timelines have been released. 

Despite warnings from the Centers for Medicare & Medicaid Services (CMS) back in July that it would likely take some time to for states to come into compliance with new regulations, a class action lawsuit has been filed in Hawaii over the state’s failure to provide Medicaid coverage for ABA therapy. We will have to wait and see if this gets the gears of Hawaiian state bureaucracy to move faster and whether similar suits are filed in other states that are slow to comply. 

Navigating Medicaid and obtaining services is complicated and different in every state. Many parents find it much easier to obtain the right services and coverage with the help of local autism advocates and service administrators. Organizations like Shema Kolainu Hear Our Voices School and Center for Children with Autism, serving children in all five boroughs of New York City help parents with Medicaid service coordination, early intervention programs, evaluations, speech therapy, occupational therapy,  physical therapy, and applied behavior analysis.

The Best Careers For Autistic People

While unemployment rates are improving across the US, for people with Autism Spectrum Disorders (ASD), finding and keeping a job can still be an elusive pursuit. Even though many people on the autistic spectrum have the necessary technical skills to complete a job’s duties as well as or better than their neurotypical peers, landing a job that lends financial security and personal fulfillment can be much more difficult. 

The transition from school to employment is exceptionally difficult for autistic people. Preparing for a career in a specific field while still in high school or even earlier, can make that transition a little easier and will also allow them to build their skills and experiences with a focus that will give them an advantage over other candidates. There are some exciting new resources available to help people on the spectrum prepare for and obtain employment. The International Center for Autism Research and Education, also known as ICare4Autism helps autistic adults ages 18 and up find the vocational and employment training services they need from semi-skilled to high-functioning individuals. To learn more about ICare4Autism’s Global Autism Workforce Initiative, visit:http://www.icare4autism.org/global-autism-center/comprehensive-autism-workforce-development-initiative/ 

For many autistic adults, the hardest part of any job can be the social aspect. Because the subtleties of social interactions and political positioning associated with most corporate careers can be lost on people with ASD, and adapting to changing situations and requirements can be extremely difficult for them, we’ve researched the best jobs and work environments for autistic people.

Of course, talents, skills, interests, and level of functionality are as individual as people with ASD, and should be weighed and balanced on an individual basis before choosing a career path. These are simply broad recommendations based on the most common characteristics associated with the autism spectrum.

Computer Coding and Software Testing: For the autistic individual who has an uncanny eye for pattern and detail, this is definitely an avenue worth pursuing. Several software companies now give preference to candidates with autism because they can be much better at these jobs than people whose brains lose focus or can overlook tiny syntax errors that translate into software bugs. These jobs also have limited social interaction and exposure to like-minded people. 

Scientific Research: They call it the scientific method for a reason – it’s methodical. High functioning autistic people often thrive on meticulous, repetitive activities that require objectivity and extreme focus. There are some aspects that some people with ASD may find difficult, like obtaining funding and managing staff, but lab work itself can be ideal. 

Working With Animals: Many autistic people have difficulty interacting with other people, but have a talent for relating to animals. Therapy dogs and cats (yes, therapy cats!) are becoming more and more common for autistic people because the animals have a soothing affect. Autistic people can thrive in work environments that have more interaction with animals than people, such as veterinary clinics and farms. 

Stocking Shelves: Whether in a warehouse, library, or retail environment, inventory is (usually) filed systematically. There’s not a lot of social interaction required and very little chance of unexpected obstacles to pop up. Once a person with autism understands the established shelving system, they can thrive in a position like this where their day can be very structured and they are free to go about the systematic execution of their tasks. 

Mechanics: Autistic people with good fine motor skills often excel with mechanical maintenance jobs. Whether motorcycles, cars, computer hardware, or heavy machinery, the ability to find the one loose wire or worn sprocket in a massively complicated schematic can be right up the autistic alley. This is also a field where social skills and graces are not a huge priority. Many high functioning autistics are used to their friends and family asking them to fix things, so they might as well get paid for it. There are excellent entrepreneurial prospects here too.

Data Entry: In the age of big data and digital marketing, data entry is a huge part of most marketing and corporate companies. Because it is repetitive, requires attention to detail, a systematic approach, non-social, and can often be completed via telecommuting, this can be a great way for people on the autism spectrum to earn a paycheck. 

Many people who have autism spectrum disorders have amazing artistic abilities or exceptional math skills. Obviously they should pursue careers that allow them to best apply their talents. For all people, though – autistic or not, the work environment, interpersonal communication, and structure should be considered just as important as the required technical skills and salary.

Broadway Goes Autistic

It can be difficult, if not impossible, for many parents of autistic children to expose their kids to a full range of cultural experiences because of their potentially disruptive behavior and other parent’s judgment and intolerance. This is why the Theatre Development Fund’s Autism Theatre Initiative is presenting an autism-friendly performance of Disney’s The Lion King on Saturday, September 28, 2014. 

The mission of the Autism Theatre Initiative is to make theater accessible to children and adults with autism and their families. The fact that tickets sold out in just three days shows there is a real demand for autism-friendly entertainment and family activities. 

“From the feedback we’ve received of the past seasons, this community is thrilled to finally have access to the performing arts,” said Lisa Carling, TDF’s Director of Accessibility Programs. “Not only do autism-friendly performances introduce the world of theatre to the person on the autism spectrum, but it allows a family to experience it together in a supportive environment with no judgments. The word is spreading as we are currently consulting with organizations from coast to coast on how to present autism-friendly performances. We thank Disney Theatricals for allowing us to present that first performance in 2011 and continuing to support the program so enthusiastically.” 

In addition to only selling tickets to the autism-friendly performances to groups that include individuals on the autism spectrum (at a discounted rate) to ensure an understanding, judgment-free audience, slight adjustments are made to the productions to make them more autism-friendly. Jarring sound and light cues are modified while strobe lights are completely eliminated. The theater lobby provides designated quiet and activity areas staffed with trained autism professionals to help make anyone who leaves their seats during the performance feel more comfortable. To learn about future Autism Theatre Initiative performances, vist www.tdf.org/autism.

Temple Grandin Spreads Hope and Honesty

Temple Grandin, author, inventor, animal whisperer, and autistic icon delivered a message balanced with hope and honesty last night at the University of San Diego.  More than 600 people were completely enraptured by the woman in her 60’s known best for her ability to understand animals (she was the subject of the 2006 HBO documentary, “The Woman Who Thinks Like a Cow”).

Grandin grew up autistic and attributes her success to a devoted mother and dedicated teachers. As a world-renowned livestock behavior expert, she is living proof of what it is possible for autistic people to achieve and serves to inspire parents to invest in their children’s futures.  

As a child, living with autism made life very difficult. She didn’t speak until three and a half, was mocked and bullied as an adolescent, and struggled to learn to navigate social interactions that were completely foreign to her. As an adult, however, she found her autism to be a great advantage. She credits her autism with her deep empathetic connection to animals and understanding of their nonverbal, sensory comprehension of the world. Her understanding of how animals receive and process sensory information enabled her to design humane cattle transportation systems that are currently used by more than half the cattle processing centers in America. 

Temple Grandin is an excellent role model for people with autism, and she is a tireless advocate.  In her talk last night, she delivered a twofold message. First, she detailed the differences between autistic and “normal” brains, using herself as an example.

“Parents must understand those differences to understand, for example, why a flickering light, a loud noise — or the click of a photographer’s camera — can be unbearable,” Grandin explained. 

The other half of her message was an honest, unsentimental instruction for parents on how to train push their children to learn the social skills necessary for them to become independent adults. She warned that children who aren’t pushed to do things they don’t want to or are afraid of will not grow. Parents and teachers must present a united front because, she says, “autistic children are masters of manipulation.”

She urged parents to take advantage of information, services, and materials that are freely available to help educate their children. With all the free information online about schools, therapy, medication, and resources, she is frustrated by parents who don’t put in the work to access this information. 

“I am appalled by the lack of resourcefulness. A parent came up to me and said, how do I find a college for my kid? Well, I got back home, I typed Ohio and colleges,” she stated unsentimentally to a laughing audience. “They had done no work.”

Temple Grandin’s honest delivery of a somewhat critical speech was met with cheers. The audience was a mix of fans of her work with autism and animals, and all gratefully accepted her message. 

“The thing I’ve appreciated about Temple Grandin for many years is her unabashed honesty,” said Mary Lau, who works at a school that has autism spectrum children. “And from that, I can glean a lot about the autistic community and the education community in general.”

Video Game Therapy for Autistics

A recent study from Vanderbilt University found that what children with autism hear is often out of sync with what they see. Dr. Mark Wallace, who lead the study, describes it as, “a badly dubbed video.”

By comparing 32 high-functioning children with autism to 32 typically developing children, matched by age, sex, and IQ, researchers found that the children with autism had an enlargement in their temporal binding window (TBW). Simply put, their brains had trouble linking visual and auditory events that happened within a certain period of time.

“Children with autism have difficulty processing simultaneous input from audio and visual channels. That is, they have trouble integrating simultaneous information from their eyes and their ears,” said co-author Stephen Camarata, Ph.D., professor of Hearing and Speech Sciences. “It is like they are watching a foreign movie that was badly dubbed, the auditory and visual signals do not match in their brains.”

The second part of the study found that the autistic children also showed weakness in how strongly they associated audiovisual speech stimuli. Dr. Wallace believes this explains why autistic children often cover their ears or eyes. “We believe that one reason for this may be that they are trying to compensate for their changes in sensory function by simply looking at one sense at a time. This may be a strategy to minimize the confusion between the senses.” 

Building on the findings of this study, researchers are now in the testing phase of an interactive video game that they designed to retrain autistic brains in how they link different sensory input. As Dr. Wallace describes, “It basically takes the tuning of the nervous system and shapes it, so that they get better.”

Tablets Help Autistic Kids Maximize Language Skills

A recent study published in the Journal of the American Academy of Child & Adolescent Psychiatry suggests that using tablets with speech generating applications in the context of blended, adaptive treatment can help minimally verbal children make significant and rapid gains in their language skills.

For the study, 61 minimally verbal children with autism aged 5to 8 years old participated in six months of therapy geared towards improving language skills, play skills, and social skills. Half of the children were given a tablet to use during the therapy sessions loaded with a speech-generating app programmed with pictures objects used during the therapy. These children were able to touch a picture of an object they were using in therapy and hear an audio file of the objects’ names.

The study found that the children with tablets were much more likely to begin using language on their own, especially when they used the tablets from the beginning of therapy. The children appeared to have retained their skills when followed up on three months later.

“It was remarkable how well the tablet worked in providing access to communication for these children,” said Connie Kasari of the University of California, Los Angeles. “Children who received the behavioral intervention along with the tablet to support their communication attempts made much faster progress in learning to communicate, and especially in using spoken language.”

Shema Kolainu Hear Our Voices School and Center for Children with Autism is launching it’s iPad program this year. We will be sure to keep you posted!

Connecting the Dots: Leaky Gut, Gluten-Free, Casein-Free, Low-Carb, and Probiotics

We’ve been talking a lot lately about the impact of diet on Autism Spectrum Disorders (ASD), even though they are typically considered a neurological condition.  Many people with an ASD experience chronic digestive symptoms that, when treated often results in the alleviation of behavioral and neurological symptoms. But we talk so much about gluten-free diets, casein-free diets, low-carb diets, probiotics, and leaky gut syndrome separately from each other that it gets really confusing. Do these approaches contradict each other? Is one better than the others? What does it all mean?

We’ll start with leaky gut. The Centers for Disease Control and Prevention (CDC) concluded that children with ASD are three times more likely to suffer from leaky gut syndrome, inflammation in the digestive tract that is characterized by chronic diarrhea or constipation. People with leaky gut syndrome are said to have increased intestinal permeability, which means the lining of their digestive tract allow things to be absorbed that shouldn’t, including gluten, bad bacteria, undigested food particles, even toxic waste. A strong indication of leaky gut is multiple food sensitivities. Partially digested proteins (like gluten) and fats are absorbed into the blood stream, causing an allergic reaction aka inflammation. This allergy won’t cause sneezing, but bloating, fatigue, joint pain, headaches, skin issues, weight gain, or digestive issues and can develop into inflammatory bowel disease, arthritis, eczema, psoriasis, depression, anxiety, migraines, muscle pain, and chronic fatigue.

Leaky gut also affects the brain. Proteins like gluten and casein can act similarly to an opioid drug on the brain when absorbed and recirculated by the bloodstream. This is why autistic people respond so well to gluten-free, casein-free, and low-carb diets. All of these approaches minimize the proteins and food allergens that are most likely to wreak havoc when absorbed inappropriately by a leaky gut.

So where do probiotics come in? One of the main causes of leaky gut syndrome, in addition to poor diet, chronic stress, and toxin overload, is bacterial imbalance. Many of us are born with an imbalance of good and bad gut bacteria inherited from our mothers, or develop them through an overuse of antibiotics, sensitivity to chlorinated or fluoridated drinking water, or a lack of probiotics rich foods in our diets. Research from Arizona State University revealed that children with autism tend to have significantly greater risk for imbalanced bacteria levels, which can cause leaky gut, which causes inflammation, which triggers an autoimmune response. So, probiotics taken in supplement form and in foods like yogurt and kefir rebalance digestive bacteria and help the leaky gut that makes gluten and casein a problem in the first place.

So, while we often talk about these different nutritional approaches separately, they are related and should be integrated for maximum effect. It’s a good idea to be tested for food allergies and eliminate them immediately from your or your children’s diet. If you suspect leaky gut syndrome, you can find many different diet protocols to set you on your way to a healthy gut, which may someday process proteins like gluten and casein without adverse reaction. Add foods rich in probiotics to your or your child’s diet like yogurt and kefir. Other foods thought to help heal the gut include bone broth, fermented vegetables, coconut (in every form), and sprouted seeds.

Autistic Super Hero May Be Worth More Than Face Value

Autistic Super Hero Takes On Aliens and Emotions in "Face Value"

There’s a new super hero in town and he’s already a huge hit with the Autism Community. Just days after its release, the first issue of Face Value, the world’s first comic book series featuring an autistic hero, is sold out.  Parents of autistic children are flocking to buy (or back-order) the comic that not only shows children that their ASD (Autistic Spectrum Disorder) can be an asset, but aims to help them better understand emotions.

The year is 2072 and the Steampunk (a futuristic world powered by steam, rather than electricity) Earth is threatened by a race of aliens who have declared humans dangerously emotional. Enter our hero, Michael, a middle school aged boy with autism who must fight through social pressures, misunderstandings, and bullying on his way emotional understanding of himself and others. He’s helped along on his journey of emotional discovery of his therapeutic robot support staff and science.

The comic books are also aided by science, employing tested teaching techniques of visually encoding emotions. In other words, the comic features exaggerated drawings of the characters’ facial expressions, linking them with specific emotions.

Founded by Dave Kot in the United Kingdom, Face Value aims to provide both education and entertainment focusing on emotional understanding in social situations. It’s based on an ideal of Comic Awareness; both the use of comic books as a means to share a message like autism awareness, and helping people with ASD to decode emotions by being made aware through comics.

“Everyone can learn more about emotions,” says Kot, “anyone with any level of autism can learn and utilize this.” The Face Value series is geared towards the middle school set and pledges to be strictly PG rated, but it may lead to comics for a more mature audience.

The first issue of the comic is sold out, but the company urges parents to ask their local comic books store to back order it – and pre-order the next issue to be released in October. The first issue is also available for digital online purchase.  Whether or not the comic unlocks emotional understanding for its autistic readers, it can only help them to see that what makes them different also makes them special. It may even help people without autism understand their autistic peers a little bit better.

Bully Preparedness Is Even More Important for Autistic Youths

Bullying is a pervasive problem in private and public schools alike, and unfortunately children and teens with Autism Spectrum Disorders (ASD) are easy targets. 46 percent of all middle and high school aged children with ASD reported being bullied in 2011, while a staggering 70percent of autistic youths in mainstream schools were bullied. As we head back to school and for many, back to bullies, it’s time to review a few things we can do to help safeguard our autistic children against bullies.

As always, our first bit of advice: talk to your child. Help them understand what bullying means and why it’s wrong to mistreat others. Offer specific examples of appropriate interactions, but also help them know what kinds of behaviors to look out for in others. If someone pulls their hair, they may know it hurts, but them may not know if it’s bullying. Keep the lines of communication open so they can come to you with any questions.

Next, make a recess game plan with your child. Make sure they have been introduced to playground monitors, cafeteria aides, and other school staff so they can feel comfortable going to them if they are bullied. Tell them to always play where they can see a playground monitor and never to follow bigger kids or a group of kids away from adult supervision. Try making a detailed recess schedule (5mins on swings, 5 mins jumping rope…).

Make a plan for what they will do if they are bullied. If your child recognizes that they are being bullied and they know what to do next, it may help to reduce some of their terror and anxiety while it is happening. Make sure they know to report it immediately to their teacher and to you.

Talk to your child’s teacher, bus driver, cafeteria aides, anyone at the school who may be able to keep an eye out for your child. If they are aware of your child’s special needs, they will happily help keep him safe. Keep an open dialogue so they will report anything they see, but also so your child knows whom they can trust when they get into trouble.

Talk to other parents. Get to know the parents of other children with disabilities at your school, and make sure your children get acquainted. They may not become best friends, but they can help look out for each other. Many children who are bullied are too ashamed or afraid to report their abuse to a teacher, parent, or official. Help your kids help each other by knowing how to report bullying they see happening to someone else.

Every school has an anti-bullying policy, yet it seems that we hear of worse and worse cases of bullying every year.  As school resources get stretched further and further, parents have to get involved more and more to protect their kids and safeguard their education.

The Birds, The Bees, and Autism

A recent study from the University of Toronto found that autistic adults are at greater risk of sexual victimization and indicates lower levels of sexual knowledge than their typically-developing peers.  The study revealed that 78% of the participants on the autism spectrum reported at least one instance of victimization versus less than 50% of the non-autistic control group.

The survey-based study asked participants a range of questions regarding unwanted contact, knowledge of reproductive health, contraception, and sexuality. Compared to the control group, the ASD participants were also found more likely to turn to the Internet and television for sexual information rather than their parents, teachers, or peers.

The best way to safeguard our children against sexual victimization is through education, but having “The Talk” with a child with autism can be even more difficult and awkward (especially for the parent) than what’s already an uncomfortable rite of passage for any parent. That’s why we’ve pulled together some basic tips to help you keep your autistic children safe by talking to them about sex.

It’s an awkward subject, which is why we often use euphemisms and metaphors to talk about sex, especially with children. For a child with autism who is extremely literal, however, talk about birds and bees and flowers and trees can be extremely confusing and lead to difficult misunderstandings. That’s why it’s very important to always be as clear and specific as possible. Think about how your child may interpret your words before you choose them. Preparing your son for his voice to change and get deeper like Daddy’s will probably cause less anxiety than bracing them for their voice to “break.”

Be open to any questions and ready to answer clearly. If you don’t know the answer to one of their questions, be honest – don’t make guess or make something up. Simply answer, “I’m not sure, why don’t we look that up together?” Your child may ask awkward questions at inappropriate times, so get the whole family on board with the stock answer, “That is a good question, but we’ll talk about it when we get home.” Just be sure to talk about it as soon as you get home so your child continues to go to you with their questions.

Start the dialogue as early as possible by talking with your child about their body and any questions they may have. You want them to feel comfortable talking with you, get used to coming to you with their questions, and develop an awareness of their body. This will help pave the way for the puberty talk.

Children with an Autistic Spectrum Disorder (ASD) often have difficulty with transitions and need more time to adjust to changes than their non-autistic peers. That’s why it’s important to start preparing your child for puberty early. Discus the changes they will experience as clearly and calmly as possible to minimize their anxiety when it happens. Again, be prepared for questions beyond the standard, “Why?” and know how you will handle questions you don’t have answers to.

Don’t be afraid to use pictures (that you deem appropriate) if your child is a visual learner. Remember, you are doing this to protect them. You can show your child pictures of you from infancy to adulthood and notice and point out the more obvious ways that you have changed as you grew up. The idea is to introduce them to the notion of physically changing in a way that isn’t scary. You can also use basic outlines of the body to assist with more intimate lines of discussion.

Talk to your child’s teachers and school. Find out what and how they will handle sexual education every year so you can make sure that home and school explanations and terminology are consistent.  You may determine that the school’s curriculum isn’t paced appropriately for your child or that it assumes more prior knowledge than your child is prepared with. You may need to supplement the school’s lessons by helping your child understand them on a deeper, clearer level. Children with ASDs may need to understand why we have to bathe every day before they accept it. Also concepts like friendship and appropriate behaviors may need to be clarified at home.

Don’t be afraid to get your pediatrician involved in the conversation. They are already experts at not being embarrassed by awkward conversations and this will help prepare your child for future examinations and conversations about contraception and sexual health.

Building your child’s understanding of private vs. public behavior as well as appropriate behavior for both themselves and others can be a bit tricky. Set guidelines about whom your child is allowed to discuss certain subjects with and start to introduce the idea of private vs. public spaces. Let them know what behaviors are only acceptable in the bathroom or the bedroom and when it’s necessary to knock before entering a room.

It can be painful to see our children grow up, and it is a natural instinct for many parents to maintain their children’s innocence and avoid awkward conversations by keeping them in the dark about sex-related issues. For children with autism, that darkness can be a very dangerous place. Misinformation or inappropriate relationships are readily available on the Internet, so be sure to set filters and blocks to safeguard your child while online. Also monitor their computer usage and check their browser history – this may help you understand what information your child is looking for and ensure you are the one to provide it. Keep your autistic child, teen, or young adult safe by always knowing where they are and whom they are with. Always be ready to field their questions, and never be shy about asking them questions. By establishing open and clear communication with your child about their body and sex, you are paving the way for a safer future.